ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC RETIREMENT PLAN
|
2013
|
364487406
|
2014-07-15
|
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2010-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6309090500
|
Plan sponsor’s
address |
383 SCHMALE ROAD, CAROL STREAM, IL, 60188
|
Signature of
Role |
Plan administrator |
Date |
2014-07-15 |
Name of individual signing |
MARK ERICKSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-07-15 |
Name of individual signing |
MARK ERICKSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC RETIREMENT PLAN
|
2012
|
364487406
|
2013-05-07
|
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2010-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6309090500
|
Plan sponsor’s
address |
383 SCHMALE ROAD, CAROL STREAM, IL, 60188
|
Signature of
Role |
Plan administrator |
Date |
2013-05-07 |
Name of individual signing |
MARK ERICKSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-05-07 |
Name of individual signing |
MARK ERICKSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC RETIREMENT PLAN
|
2011
|
364487406
|
2012-07-06
|
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2010-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6309090500
|
Plan sponsor’s
address |
383 SCHMALE ROAD, CAROL STREAM, IL, 60188
|
Plan administrator’s name and address
Administrator’s EIN |
364487406 |
Plan administrator’s name |
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC |
Plan administrator’s
address |
383 SCHMALE ROAD, CAROL STREAM, IL, 60188 |
Administrator’s telephone number |
6309090500 |
Signature of
Role |
Plan administrator |
Date |
2012-07-06 |
Name of individual signing |
MARK ERICKSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-07-06 |
Name of individual signing |
MARK ERICKSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC RETIREMENT PLAN
|
2010
|
364487406
|
2011-07-08
|
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2010-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6309090500
|
Plan sponsor’s
address |
383 SCHMALE ROAD, CAROL STREAM, IL, 60188
|
Plan administrator’s name and address
Administrator’s EIN |
364487406 |
Plan administrator’s name |
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC |
Plan administrator’s
address |
383 SCHMALE ROAD, CAROL STREAM, IL, 60188 |
Administrator’s telephone number |
6309090500 |
Signature of
Role |
Plan administrator |
Date |
2011-07-08 |
Name of individual signing |
MARK ERICKSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-08 |
Name of individual signing |
MARK ERICKSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|